A Comparative Study Of Long Term Glucose Control And Risk Of Superficial Surgical Site Infection In Diabetics Vs Non Diabetics Undergoing General Surgery

Abstract

Surgical site infections (SSI) are the infections present in any location along a surgical tract after a surgical procedure. They are the third most common hospital-acquired infection and account for 14% to 16% of all infections. Diabetic patients have shown impaired wound healing and thus have an increased risk of morbidity after surgery from SSI.Tight glucose control in diabetic patients is now widely accepted as the goal in long term management because it demonstrates improvement in microvascular complications. However, the impact of HbA1c on surgical outcome is still being defined. Studies have been done proving increasing HbA1C levels correlated with increasing complications and reduced long term survival in CABG patients. But,there are no previously reported analysis of surgical outcomes of patients based on preoperative HbA1c levels presenting for general surgery.Hence, this study was done to see HbA1c as a predictor of superficial surgical site infection and to know the correlation between them. AIM: To compare the HbA1c levels in diabetics and nondiabetics and the risk of surgical site infection after any elective general surgery. PATIENTS AND METHODS: All participants diagnosed with type 2 diabetes and equal number of non-diabetics undergoing elective surgical procedures were selected from January 2012 to December 2012.HbA1c levels of diabetic patients were taken within 30days of surgery and compared with HbA1c levels of those of non-diabetics. Surgical site infection was assessed post operatively at 3rd, 5th , 7th, 15th , 30th days. RESULTS: High levels of HbA1c were correlated with rate of SSI and p value was <0.005 CONCLUSION: Plasma hemoglobin A1c is an indicator of measuring glycaemia over 2-3 months. Increase in this levels has shown to be associated with significantly higher rate of SSI and medical morbidity. Hence, a strict control on glycemia must be performed preoperatively and postoperatively to reduce such complications and to obtain better outcome in diabetic patients.